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On The Articulations   

than in dislocation inward, both because the head of the femur and the
neck of its articular extremity, being naturally oblique, have
formed a bed under a considerable portion of the hip, and because
the extremity of the foot is not forcibly turned outward, but is
nearly in a line with the body, and is even inclined more inwardly.
When, then, the articular extremity of the femur has worn out a socket
for itself in the flesh where it was lodged, and the flesh is
lubricated, it ceases to be painful in the course of time, and when it
becomes free from pain, they can walk without a staff, if so inclined,
and they can support the body on the injured limb. From usage then, in
such cases, the fleshy parts are less enervated than in those which
have been mentioned a little before, still, however, they lose their
strength more or less; but in general there is more enervation when
the dislocation is inward than when it is outward. Some of them, then,
cannot wear their shoes, owing to the unbending state of their leg,
and some of them can. But when this dislocation takes place in
utero, and when the dislocation having occurred at any time before
manhood, from violence, has not been replaced, or when from disease
the articular extremity has started from its socket, and is
displaced (for many such cases occur, and from some of them, if the
femur become necrosed, obstinate suppurations requiring the use of
tents are formed, and in certain of them the bone is laid bare),
whether the bone become necrosed or not, the bone of the thigh is much
shortened, and does not usually grow like the sound one, the bones,
too, of the leg, become shorter than those of the other, but in a
small degree, for the same reasons that were formerly stated; such
persons can walk, some of them in the same fashion as adults having an
unreduced dislocation, and some of them walk with the whole foot on
the ground, but limp in walking, being obliged to do so by the
shortness of the limb. Such is the result, even though they be
carefully and properly trained in the attitudes before they have
strength for walking, and in like manner also, after they have
acquired the necessary strength; but those persons require the most
care who were very young when they met with the accident, for, if
neglected while children, the limb becomes entirely useless and
atrophied. The fleshy parts of the entire limb are more wasted than
those of the sound limb, but this is much less apt to happen in
their case than in dislocation inward, owing to usage and exercise, as
they are speedily able to make use of the limb, as was stated a little
before with regard to the weasel-armed (galiancones).

56. There are persons who, from birth or from disease, have
dislocations outward of both the thighs; in them, then, the bones
are affected in like manner, but the fleshy parts in their case lose
their strength less; the legs, too, are plump and fleshy, except
that there is some little deficiency at the inside, and they are plump
because they have the equal use of both their legs, for in walking
they totter equally to this side that. Their nates appear very
prominent, from the displacement of the bones of the joint. But if
in their case the bones do not sphacelate (become carious?) and if
they do not become bent above the hip-joint, if nothing of this kind
happen to them, they become otherwise sufficiently healthy, but the
growth of all the rest of the body, with the exception of the head, is

57. In dislocations of the head of the femur backward, which
rarely occur, the patient cannot extend the leg, either at the
dislocated joint, or at the ham, to any extent, and of all the
dislocations, this is the variety in which the patients have the least
power of making extension at the groin and the ham. But, moreover,
this also should be known (for it is a valuable piece of knowledge,
and of much importance, and yet most yet most people are ignorant of
it), that persons in health cannot extend the joint at the ham, if
they do not extend the joint at the groin at the same time, unless

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